EPILOGUE
Today in Afghanistan, with IEDs becoming the Taliban’s weapon of choice, those injuries that do not kill our Marines outright or cause traumatic brain injuries will inevitably lead to multiple amputations. Troopers on foot patrol often lose both legs and one arm from the blast. We all walk with our arms swinging, whether it is down the block in front of our homes or on patrol outside of a supposed Taliban village. In Afghanistan, the body usually shields one arm whether the blast is behind, to the side, or in front of the marine.
To deal with these injuries, the military has recently developed a new kind of tourniquet specific for Afghanistan called a CAT or “Combat Action Tourniquets.” Two CATs are now being issued to every marine going to or already in Afghanistan. Each CAT has a black plastic cinch device around it that when pulled, tightens the tourniquet, cutting off the blood supply to the damaged or missing limb.
Today the marines in Afghanistan who go out on foot patrols go out with the tourniquets already loosely strapped high on their thighs so that the tourniquets can quickly be tightened immediately after a leg or a foot is blown off. No one ordered the marines to go out with tourniquets already in place. Abandoned in “The Grave Yard of Empires” they have simply decided on their own to give themselves the chance of at least going home alive.
*****
In May of 2010, the number of American dead in Afghanistan passed 1,000 after a suicide bomber in Kabul killed at least five United States service personnel. The ages of those killed clearly show that American troops are dying younger, often right out of boot camp. The apparent reason that the age of those killed in Afghanistan is dropping is that the pool of experienced combat troops is shrinking. Without a draft, the military has to send younger and less experienced soldiers and marines into the fight.
From 2002 to 2008, the average age of service members killed in action in Afghanistan was twenty-eight; in 2009, that age quickly dropped to twenty-six. This year, the 125 troops killed in combat had an average age below twenty-five. These are getting close to Vietnam ages. The other number that is similar to ’Nam is that the incidence of those killed to those wounded is going up as the number of IED attacks increase and the devices themselves become more powerful.
More of our troops are killed right then and there when the IED explodes, rather than being wounded. A bomb estimated at over 2,000 pounds recently killed seven American soldiers riding in a troop carrier. No one survived long enough to make it to a med-evac chopper, much less a hospital. That too is like ’Nam. Dead the moment you are hit.
ACKNOWLEDGMENTS
Thanks to Bob Aulicino for a cover that captured the book, Angela Werner for her tireless editorial efforts, Kendra Millis for the indexing that mentions everything worth mentioning, and my agent Claire Gerus who brought the manuscript to publisher Don Bracken, who saw a book he had to publish.
GLOSSARY
AK-47–Communist 7.62-mm semi-automatic and fully automatic assault rifle
AK-50–The newest version of the AK-47. Some have a permanently mounted “illegal” triangular bayonet, which leaves a sucking wound that will not close.
AOD–Administrative officer on duty
APC–Armored personnel carrier
AR–Army regulation
ARVN–Army Republic of Vietnam
Bandoliers–Belts of machine-gun ammunition
Boonies–The countryside
Bouncing Betty–A mine with two charges: one to propel the explosive charge upward and the other set to explode at about waist level.
Bravo–Army designation for infantry man
Burr Holes–Surgical holes drilled through the skull so that the brain and its surrounding vessels can be operated on.
CA–Combat assault. Term applied to taking troopers into a hot landing zone.
Chopper–Helicopter
Cobra–Heavily armed assault helicopter
CP–Command post
Dust Off–Medical evacuation mission by helicopter. The term refers to the great amount of dust thrown up by the rotors as the med-evacs come in to land.
Enucleation–Surgical removal of the eye
ENT–Ear, nose, and throat
Fire Base–An artillery battery set up to give fire support to surrounding units
FO–Forward observer
Grunt–Originally slang for a marine fighting in Vietnam, but later applied to any soldier fighting there.
H and E–High explosive
Horn–Radio microphone
ICU–Intensive-care unit
Intubate–To thread a hollow tube down into the windpipe to facilitate breathing.
IV–Intravenous injection
KIA–Killed in action
LOH–(pronounced loach) Light observation helicopter
LRRP–Long-range reconnaissance patrol. Now called LRP (long-range patrol). Initially four- or five-man teams that would go out for recon; now ten- to twenty-man ambush patrols.
LZ–Landing zone
M-16–American 5.56-mm infantry rifle
M-60–American 7.62-machine gun
MACV–Military Assistance Command Vietnam
Med Cap–Medical civil assistance program for Vietnamese civilians
MOS–Military occupational specialty
NCO–Noncommissioned officer
Nephrectomy–Surgical removal of a kidney
NPD–Night perimeter defense
NVA–North Vietnamese Army
OR–Operating room
Point–The lead man on a patrol
RPD–A 7.62-mm Communist machine gun with a 100-round, beltoperated drum that fires the same round as the AK-47.
RPG–A Communist self-propelled rocket.
SF–Special Forces
SI–Seriously ill
Slick–Helicopter for transporting troops
TAC–Tactical air strikes
Thorazine–A tranquilizer
Titers–Amount of anti-body in a serum
TOC–Tactical operation center, usually battalion level and above
Track–Any vehicle that moves on treads instead of wheels
Triage–The sorting out of patients according to the criticalness of their needs, i.e., those who need immediate surgery versus those who need only minimal care.
USARV–United States Army Republic of Vietnam
VC–Viet Cong
Vena Cava–The large vein draining blood back to the heart, the superior vena cava draining the whole upper half of the body, and the interior vena cava draining the lower extremities and trunk.
Ventricular Shunts–Tubes, surgically placed, which drain excessive fluid from the ventricles of the brain.
VSI–Very seriously ill. Army designation for those troopers who may die without immediate and definitive medical care.
WP–White phosphorous
REFERENCES AND RECOMMENDED READING
Forward
“Iraq and Vietnam”, Foreign Affairs, Nov./Dec. 2005.
Moore, Lt. General Harold G. and Joseph L. Galloway. We Were Soldiers Once … and Young. New York: Random House, 1992.
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Forty Years of War
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RAND Corporation’s Center for Military Health Policy Research, 2008.
The Late Great 1968/Welcome to the Army
Glasser, Ronald J. 365 Days. New York: George Braziller, 1971.
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Zama/The Wounded
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The Medics/Then and Now
Cramer, Eric. “Technology Boosting Survival Rate in Iraq.” Army News Service, Oct. 31, 2003.
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America’s Wars/An Autopsy Report
Browdon, Mark. Blackhawk Down. Penguin Books, 1997.
Herbert, Bob. “Dangerous Incompetence.” New York Times, June 30, 2005.
Galloway, Joseph. “Now is the Time for a Clear-Eyed Look at Where We are in Iraq.” Knight-Ridder Newspapers, June 1, 2005.
Galloway, Joseph. “Learning Lesson of Vietnam All Over Again.” Knight-Ridder Newspapers, July 6, 2005.
Galloway, Joseph. “Ia Drang: The Battle That Convinced Ho Chi Minh He Could Win.” Vietnam, Dec. 2010.
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Med-evacs and Gunships
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Fall, Bernard. Hell in a Very Small Place. Lippincott, 1966.
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Kitfield, James. “Ambulance in the Air.” National Journal, May 2010.
Street Without Joy. Stackpole, 1964.
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Teleconferencing/More than Six Degrees of Separation
Brown, David. “Teleconferencing From a War Zone Improves Treatment for Wounded Soldiers.” Washington Post, Oct. 30, 2010.
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All the Toms/Iraq 2004
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Shell Shock/The Shattering of Minds
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The Wars Within
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Multiple Deployments/Brains at Risk
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Robert, Richard. “Impact on the Brain.” Scientific American Mind, Dec. 2008/June 2009.
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The Bleeding Wars
Bumiller, Elisabeth. “The War. A Trillion Can be Cheap.” New York Times, July 25, 2010.
Galloway, Joseph. “Doomed to Repeat History in Afghanistan.” McClatchy Newspapers, Feb. 27, 2009.
Galloway, Joseph. “Learning the Lessons of Vietnam all over again.” Knight-Ridder Newspapers, July 6, 2005.
Galloway, Joseph. “Six Lessons for President Obama.” McClatchy Newspapers, May 8, 2009.
Broken Bodies, Shattered Minds: A Medical Odyssey From Vietnam to Afghanistan Page 24